Lacaine F, LaMuraglia G M, Malt R A
Ann Surg. 1985 Dec;202(6):729-34. doi: 10.1097/00000658-198512000-00012.
Multivariate analyses correlated short-term survival and long-term survival with clinical data from 141 patients with portasystemic shunts for bleeding esophageal varices over the 8 years from 1974 through 1981. By logistic regression analysis, the elements with independent prognostic significance for operative death were an emergency operation, serum albumin and bilirubin levels, age, and sex. A cutpoint probability value of 0.75 marked the single level above which 84% of patients could be expected to survive, but below which 77% are likely to die. By a Cox regression model, elements with independent prognostic significance were identical. Male sex (p = 0.02) and prolonged partial thromboplastin time (p = 0.04) indicated a poor prognosis after an emergency operation; after an elective operation only the serum albumin level was prognostic (p = 0.02). Normal blood clotting is the major determinant of survival after an emergency shunt, and the serum albumin level chiefly determines survival after elective portasystemic decompression.
多变量分析将1974年至1981年这8年间141例因食管静脉曲张出血而接受门体分流术患者的短期生存和长期生存与临床数据进行了关联。通过逻辑回归分析，对手术死亡具有独立预后意义的因素包括急诊手术、血清白蛋白和胆红素水平、年龄及性别。切点概率值为0.75时标志着一个单一水平，高于此水平预计84%的患者能够存活，但低于此水平则77%的患者可能死亡。通过Cox回归模型，具有独立预后意义的因素相同。男性（p = 0.02）和部分凝血活酶时间延长（p = 0.04）表明急诊手术后预后不良；择期手术后只有血清白蛋白水平具有预后意义（p = 0.02）。正常凝血是急诊分流术后生存的主要决定因素，而血清白蛋白水平主要决定择期门体减压术后的生存情况。
